Research

16 pages, 469 KiB

Open AccessArticle

Exercise-Induced Hypoalgesia in Patients with Chronic Whiplash-Associated Disorders: Differences between Subgroups Based on the Central Sensitization Inventory

by Erwin Hendriks, Iris Coppieters, Lennard Voogt, Wilfried Cools and Kelly Ickmans

J. Clin. Med. 2024, 13(2), 482; https://doi.org/10.3390/jcm13020482 - 15 Jan 2024

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Abstract

Background: Physical exercise is an important element in the rehabilitation of chronic whiplash-associated disorders, with the physiological process underlying pain reduction called exercise-induced hypoalgesia. In chronic whiplash-associated disorders, exercise-induced hypoalgesia appears impaired, and the research suggests a relationship with symptoms of dysfunctional nociceptive [...] Read more.

Background: Physical exercise is an important element in the rehabilitation of chronic whiplash-associated disorders, with the physiological process underlying pain reduction called exercise-induced hypoalgesia. In chronic whiplash-associated disorders, exercise-induced hypoalgesia appears impaired, and the research suggests a relationship with symptoms of dysfunctional nociceptive processing, such as central sensitization. This study improves our understanding of exercise-induced hypoalgesia in chronic whiplash-associated disorders by examining the differences between the extent of exercise-induced hypoalgesia in subgroups based on scores on the central sensitization inventory (CSI). Methods: Data were collected from 135 participants with chronic whiplash-associated disorders who completed a set of questionnaires. Pain pressure thresholds and temporal summations were assessed before and after a submaximal aerobic bicycle exercise test. Results: We observed no interaction effect between exercise-induced hypoalgesia and the CSI scores for both pain pressure threshold and temporal summation. No overall statistical effect was measured in the analysis of the effect of time. The pain pressure threshold significantly related to the CSI. The temporal summation showed no correlation. Conclusions: During this study, we did not find evidence for a difference in the presence of exercise-induced hypoalgesia when the subgroups were created based on the central sensitization cluster calculator. Limited evidence was found for the influence of CSI scores on the delta pain pressure threshold. Full article

(This article belongs to the Special Issue Rehabilitation and Recovery from Orthopedic Trauma)

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18 pages, 3057 KiB

Open AccessArticle

Incidence and Clinical Risk Factors of Post-Operative Complications following Primary Total Hip Arthroplasty: A 10-Year Population-Based Cohort Study

by Yen-Sheng Lin, Joshua J. DeClercq, Gregory D. Ayers, Ruby J. Gilmor, Garen Collett and Nitin B. Jain

J. Clin. Med. 2024, 13(1), 160; https://doi.org/10.3390/jcm13010160 - 27 Dec 2023

Cited by 1 | Viewed by 804

Abstract

Background: Total hip arthroplasty (THA) has become a growing treatment procedure for debilitating hip pathologies. Patients experienced post-operative complications and revision surgeries according to large THA registries. To fully understand the short-term and long-term post-operative outcomes following THA, the purpose of this study [...] Read more.

Background: Total hip arthroplasty (THA) has become a growing treatment procedure for debilitating hip pathologies. Patients experienced post-operative complications and revision surgeries according to large THA registries. To fully understand the short-term and long-term post-operative outcomes following THA, the purpose of this study is to examine the incidence of post-operative complications following primary THA and to examine how this trend has changed over 10 years within community hospitals in the US using large databases. Methods: This study queried the State Inpatient Database (SID) for primary THA between 2006 and 2015. Individual patients were followed forward in time until the first instance of a post-operative complication. The multivariable logistic regression analyses were computed to examine which post-operative complications were independent predictors of pre-operative comorbidities. Results: Median age of patients was 67 years, and 56% of patients were female. Females with avascular necrosis (AVN) as an indication for THA had a 27% higher risk of complication. Females with osteoarthritis (OA) as an indication for THA had a 6% higher risk of complication. Post-operative complications occurred with higher frequencies in the first two months of THA and the highest risks of THA complications within the first 6 months. Conclusion: The most common indication is OA in elders with primary THA. Females and those of black ethnicity showed the greatest risks of THA complications. Data from our large study can be used to understand post-operative complications and readmissions after THA. Our study also provides data on risk factors associated with these complications. Full article

(This article belongs to the Special Issue Rehabilitation and Recovery from Orthopedic Trauma)

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15 pages, 756 KiB

Open AccessArticle

Active Neurodynamics at Home in Patients with Knee Osteoarthritis: A Feasibility Study

by Beatriz Serrano-García, Francisco Forriol-Campos and Juan Carlos Zuil-Escobar

J. Clin. Med. 2023, 12(20), 6635; https://doi.org/10.3390/jcm12206635 - 20 Oct 2023

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Abstract

The aim was to evaluate the feasibility of a home-based neurodynamic programme for patients with knee osteoarthritis (KO). Thirty participants (70% women) ≥ 50 years old with KO (Kellgren–Lawrence grades I–II) were included. Active mobilisation of the femoral nerve was performed at home [...] Read more.

The aim was to evaluate the feasibility of a home-based neurodynamic programme for patients with knee osteoarthritis (KO). Thirty participants (70% women) ≥ 50 years old with KO (Kellgren–Lawrence grades I–II) were included. Active mobilisation of the femoral nerve was performed at home over a period of 6–8 weeks. The feasibility of the programme was assessed using a survey that included questions related to understanding of the activity; adherence to the intervention; the burden caused by the intervention; self-perceived effects on the participant; follow-up; the barriers; and facilitators. Pain intensity, using the numerical rating scale (NRS); pressure pain thresholds (PPT); temporal assessment; pain modulation; Knee Injury and Osteoarthritis Outcome Score (KOOS), 12-item Short Form Survey questionnaire (SF-12), and the Central Sensitization Inventory questionnaire (CSI) were also collected, before and after the intervention. All patients performed the intervention, completed at least 42 days of activity, and considered the exercise adequate, with 28 participants (93.3%) reporting that the intervention was good for them. Statistically significant values (p < 0.05) were found for NRS, elbow PPT, external knee PPT, internal knee PPT, elbow CPM, CSI, and KOOS. Home-based active neurodynamic treatment has been shown to be a feasible and safe intervention for KO patients. In addition, this intervention has shown positive effects on pain and function. Full article

(This article belongs to the Special Issue Rehabilitation and Recovery from Orthopedic Trauma)

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10 pages, 647 KiB

Open AccessArticle

Perioperative Outcomes, Comorbidities, and Complications following Total Shoulder Arthroplasty in Wheelchair Users: A Retrospective Cohort Analysis of a Nationwide Database

by Kevin Prabhu, Andrew J. Nasr, Donald Kasitinon, Alison Cabrera and Yen-Sheng Lin

J. Clin. Med. 2023, 12(18), 5799; https://doi.org/10.3390/jcm12185799 - 06 Sep 2023

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Abstract

Impaired shoulder function hinders the ability of wheelchair users to maintain independence. The current state of the literature delineates the risks and benefits of surgical techniques for the management of shoulder pathologies. To the best of our knowledge, there is no study that [...] Read more.

Impaired shoulder function hinders the ability of wheelchair users to maintain independence. The current state of the literature delineates the risks and benefits of surgical techniques for the management of shoulder pathologies. To the best of our knowledge, there is no study that has investigated complications following total shoulder arthroplasty (TSA) in wheelchair users. Utilizing the PearlDiver Mariner national administrative database, 72,108 patients were identified who underwent TSA with a concurrent diagnosis of a rotator cuff tear. Two matched cohorts, one of wheelchair users and one of non-wheelchair users, were created. Due to limitations within PearlDiver, one-year outcomes, including comorbidity and complication rates and readmission statistics, were compared between the two cohorts. Each matched cohort of 869 patients underwent TSA with a concurrent diagnosis of a rotator cuff tear. The rate of readmission in wheelchair users was greater than in non-wheelchair users (24.05% vs. 9.55%, OR: 3.00, CI: 2.279, 3.946). Patients in the wheelchair cohort exhibited higher rates of complications and comorbidities (p < 0.001). Among the most likely to be readmitted after TSA were patients with osteoarthritis, pulmonary heart disease, rheumatoid arthritis, and hypertension (p < 0.05). Significant differences in surgical outcomes existed between wheelchair and non-wheelchair users in terms of preoperative comorbidities, postoperative complications, and readmission rates. Full article

(This article belongs to the Special Issue Rehabilitation and Recovery from Orthopedic Trauma)

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11 pages, 1064 KiB

Open AccessArticle

The Effect of Transcutaneous Posterior Tibial Nerve Stimulation on Pain and Quality of Life in Patients with Fibromyalgia: A Single-Blind, Randomized Controlled Trial

by İlker Fatih Sarı, İlker İlhanlı, Tuba Mızrak, Fazıl Kulaklı and Zerrin Kasap

J. Clin. Med. 2023, 12(15), 4989; https://doi.org/10.3390/jcm12154989 - 29 Jul 2023

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Abstract

This study aimed to investigate the effectiveness of posterior tibial nerve stimulation (PTNS) in reducing pain, improving quality of life, and decreasing disease severity in patients with fibromyalgia. This prospective, single-blind, randomized controlled trial included female patients newly diagnosed with fibromyalgia who had [...] Read more.

This study aimed to investigate the effectiveness of posterior tibial nerve stimulation (PTNS) in reducing pain, improving quality of life, and decreasing disease severity in patients with fibromyalgia. This prospective, single-blind, randomized controlled trial included female patients newly diagnosed with fibromyalgia who had started duloxetine treatment (30 mg/day). The patients in the study group received six sessions of posterior tibial nerve stimulation, twice weekly, 3–4 days apart, in addition to duloxetine; the controls received duloxetine only. The patients were evaluated three times (at baseline, 1st month, and 3rd month). Pain was evaluated using a numeric rating scale, the short-form McGill Pain Questionnaire, and quality of life with a 36-item short-form health survey (SF-36). Patient functional status and disease severity were evaluated using the fibromyalgia impact questionnaire (FIQ). A total of 64 patients met the inclusion criteria: 22 were ultimately included in the study group and 30 in the control group. Statistical improvements in pain and FIQ scores were observed after treatment in both groups. The SF-36 scores indicated improved vitality only in the 1st month in both groups, with no significant changes in the other quality-of-life subscales in either group. There was no statistical difference between the two groups in terms of changes in pain, FIQ, and SF-36 scores compared with baseline at the 1st month and 3rd month. The addition of PTNS to pharmacological treatment did not contribute to the reduction in pain or improvement in quality of life in fibromyalgia either in the 1st or 3rd month. NIH Clinical Trial Registration Number NCT05937711. Full article

(This article belongs to the Special Issue Rehabilitation and Recovery from Orthopedic Trauma)

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13 pages, 319 KiB

Open AccessArticle

Implicit Motor Imagery for Chronic Pelvic Pain: A Cross-Sectional Case–Control Study

by Esther Díaz-Mohedo, Gloria González-Roldán, Inmaculada Muñoz-Gámez, Virginia Padilla-Romero, Eduardo Castro-Martín, Irene Cabrera-Martos and Clara Sánchez-García

J. Clin. Med. 2023, 12(14), 4738; https://doi.org/10.3390/jcm12144738 - 18 Jul 2023

Cited by 2 | Viewed by 1169

Abstract

Implicit motor imagery (IMI), with an image laterality discrimination (LD) task, has been proposed as a useful therapeutic tool to restore body schema in patients with chronic pelvic pain (CPP). The aim of this study was to analyse the existence of differences between [...] Read more.

Implicit motor imagery (IMI), with an image laterality discrimination (LD) task, has been proposed as a useful therapeutic tool to restore body schema in patients with chronic pelvic pain (CPP). The aim of this study was to analyse the existence of differences between patients with CPP and healthy individuals in order to justify the use of IMI. An observational, cross-sectional study with non-probabilistic sampling was designed as a one-to-one matched case–control study. Through a web link designed for this purpose, a total of 40 abdominoperineal images were shown to 130 participants during the laterality task. Outcome measures were pain intensity (visual analogue scale, VAS), accuracy, response time (RT), and CPPQ-Mohedo score (Chronic Pelvic Pain Questionnaire—Mohedo). This was an observational, cross-sectional study with a total of 64 CPP patients and 66 healthy individuals. The comparative analysis between groups revealed significant differences in accuracy, CPPQ-Mohedo and VAS (p < 0.001), but not in RT; in patients with CPP, accuracy was correlated with a lower CPPQ-Mohedo score and RT and, the greater the pain intensity, the higher the CPPQ-Mohedo score and RT, and the lower the accuracy. In the LD task, the patients with CPP made more mistakes than the healthy individuals. IMI could be a useful and complementary tool in the therapeutic approach for patients with CPP. Full article

(This article belongs to the Special Issue Rehabilitation and Recovery from Orthopedic Trauma)

13 pages, 991 KiB

Open AccessArticle

A Cross-Sectional Study on Mediating Effect of Chronic Pain on the Relationship between Cervical Proprioception and Functional Balance in Elderly Individuals with Chronic Neck Pain: Mediation Analysis Study

by Abdullah Raizah, Ravi Shankar Reddy, Mastour Saeed Alshahrani, Ajay Prashad Gautam, Batool Abdulelah Alkhamis, Venkata Nagaraj Kakaraparthi, Irshad Ahmad, Praveen Kumar Kandakurti and Mohammad A. ALMohiza

J. Clin. Med. 2023, 12(9), 3140; https://doi.org/10.3390/jcm12093140 - 26 Apr 2023

Cited by 4 | Viewed by 1588

Abstract

(1) Background: Cervical proprioception maintains head orientation in space and contributes to maintaining bodily balance. Evaluating cervical proprioception in elderly individuals with chronic neck pain (CNP) and understanding how pain intensity mediates the relationship between proprioception and functional balance helps formulate treatment strategies [...] Read more.

(1) Background: Cervical proprioception maintains head orientation in space and contributes to maintaining bodily balance. Evaluating cervical proprioception in elderly individuals with chronic neck pain (CNP) and understanding how pain intensity mediates the relationship between proprioception and functional balance helps formulate treatment strategies for this population. The objectives of this study are to (a) compare the cervical proprioception and functional balance between CNP and asymptomatic, (b) investigate the relationship between cervical proprioception and functional balance ability in CNP individuals and (c) mediation effect of chronic pain on the relationship between cervical proprioception and functional balance tests (2) Methods: This cross-sectional comparative study recruited 60 elderly individuals with a diagnosis of CNP (mean age: 66.40 years) and 60 asymptomatic (mean age: 66.42 years). The cervical proprioception is measured using the target head repositing technique. The subjects were asked to close their eyes and reposition their head actively to the target position from the neutral position, and the reposition accuracy is estimated as joint position errors (JPE) in degrees. The cervical proprioception was measured in the directions of flexion, extension, and left and right rotation. The functional balance was assessed using the berg balance test (BBS) score and timed-up-and-go (TUG) test in seconds. (3) Results: The elderly individuals with CNP had increased cervical JPE compared to the asymptomatic group (p < 0.001) in all the directions tested, indicating that cervical proprioception is impaired in CNP patients. Moreover, the CNP individual functional balance is significantly impaired (p < 0.001) compared to asymptomatic. The BBS test scores were lower, and the TUG scores were higher in the CNP group. In CNP individuals, the cervical JPE showed a significant correlation with the BBS test scores (r = −0.672 to −0.732, p < 0.001) and TUG scores (r = 0.328 to −0.414, p < 0.001). (4) Conclusions: Cervical proprioception and functional balance are impaired in elderly individuals with CNP. Physical therapists and rehabilitation professionals may consider these factors during the evaluation and development of treatment strategies in elderly adults with CNP. Full article

(This article belongs to the Special Issue Rehabilitation and Recovery from Orthopedic Trauma)

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13 pages, 928 KiB

Open AccessArticle

Effects of Radiofrequency Diathermy Plus Therapeutic Exercises on Pain and Functionality of Patients with Patellofemoral Pain Syndrome: A Randomized Controlled Trial

by Manuel Albornoz-Cabello, Alfonso Javier Ibáñez-Vera, Cristo Jesús Barrios-Quinta, Inmaculada Carmen Lara-Palomo, María de los Ángeles Cardero-Durán and Luis Espejo-Antúnez

J. Clin. Med. 2023, 12(6), 2348; https://doi.org/10.3390/jcm12062348 - 17 Mar 2023

Cited by 2 | Viewed by 1954

Abstract

Although consensus has been reached about the use of therapeutic exercise in patellofemoral pain syndrome, several techniques used worldwide such as radiofrequency diathermy could be useful as complementary therapy. The objective of this randomized controlled trial was to compare the effects of adding [...] Read more.

Although consensus has been reached about the use of therapeutic exercise in patellofemoral pain syndrome, several techniques used worldwide such as radiofrequency diathermy could be useful as complementary therapy. The objective of this randomized controlled trial was to compare the effects of adding radiofrequency diathermy to therapeutic exercises in patients with patellofemoral pain syndrome. Fifty-six participants were randomly assigned either to radiofrequency diathermy plus therapeutic exercises group (n = 29) or therapeutic exercises group (n = 27). Both groups received the same therapeutic exercises, and the diathermy group additionally received monopolar dielectric diathermy for three weeks (5–3–2 weekly sessions). Data related to intensity of pain, probability of neuropathic pain, functionality, and range of movement of the knee were measured at baseline and three weeks after the intervention. Comparing pre-treatment and values obtained at the third week, significant improvements were found in intensity of pain, neuropathic pain, functionality, and range of motion in both groups (p < 0.05). The diathermy plus exercises group had significantly better intensity of pain than the control group at the end of the three weeks (p < 0.01). The addition of diathermy by emission of radiofrequency to the therapeutic knee exercise protocol is more effective than a therapeutic exercise protocol alone in the relief of intensity of pain in patients with patellofemoral pain in the immediate post-treatment follow-up compared with baseline scores. Full article

(This article belongs to the Special Issue Rehabilitation and Recovery from Orthopedic Trauma)

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Review

Jump to: Research, Other

16 pages, 1683 KiB

Open AccessReview

Non-Pharmacological Interventions for Pain Management in Hemodialysis: A Narrative Review

by Mustafa Ali Kassim Kassim, Alexandru Cosmin Pantazi, Wassan Nori, Liliana Ana Tuta, Adriana Luminita Balasa, Cristina Maria Mihai, Larisia Mihai, Corina Elena Frecus, Vasile Valeriu Lupu, Ancuta Lupu, Antonio Andrusca, Andra Maria Iorga, Radu Mihai Litrin, Irina Ion, Elena Ciciu, Sergiu Ioachim Chirila and Tatiana Chisnoiu

J. Clin. Med. 2023, 12(16), 5390; https://doi.org/10.3390/jcm12165390 - 19 Aug 2023

Cited by 4 | Viewed by 2474

Abstract

This narrative review aims to summarize non-pharmacological interventions for pain management in hemodialysis patients, assessing their potential benefits and limitations in enhancing patient well-being and quality of life. We reviewed the current literature on five primary non-pharmacological interventions: acupuncture, cognitive behavioral therapy, relaxation [...] Read more.

This narrative review aims to summarize non-pharmacological interventions for pain management in hemodialysis patients, assessing their potential benefits and limitations in enhancing patient well-being and quality of life. We reviewed the current literature on five primary non-pharmacological interventions: acupuncture, cognitive behavioral therapy, relaxation techniques, virtual reality, and alternative methods such as transcutaneous electrical nerve stimulation, music therapy, and aromatherapy. We analyzed the evidence regarding their effectiveness, feasibility, and optimal implementation strategies. The existing evidence supports the potential benefits of these interventions in managing pain and improving the well-being of hemodialysis patients. However, further high-quality research is needed to confirm their effectiveness, establish implementation best practices, and assess their long-term impact on patient outcomes. Non-pharmacological interventions hold promise for pain management in hemodialysis patients. Additional research is required to optimize these interventions and validate their effectiveness, contributing to comprehensive pain management strategies for this vulnerable patient population. Full article

(This article belongs to the Special Issue Rehabilitation and Recovery from Orthopedic Trauma)

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Other

Jump to: Research, Review

13 pages, 759 KiB

Open AccessSystematic Review

Conservative Treatment of Sever’s Disease: A Systematic Review

by Pablo Hernandez-Lucas, Raquel Leirós-Rodríguez, Jesús García-Liñeira and Helena Diez-Buil

J. Clin. Med. 2024, 13(5), 1391; https://doi.org/10.3390/jcm13051391 - 28 Feb 2024

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Abstract

Background: Sever’s disease, or calcaneal apophysitis, stands as the most prevalent cause of heel pain in children, often linked to sports like soccer, Australian football, and basketball. While various therapies are documented in the scientific literature, the standard choice is conservative treatment. [...] Read more.

Background: Sever’s disease, or calcaneal apophysitis, stands as the most prevalent cause of heel pain in children, often linked to sports like soccer, Australian football, and basketball. While various therapies are documented in the scientific literature, the standard choice is conservative treatment. Thus, the objective of this research was to assess the effectiveness of diverse conservative methods and techniques in alleviating Sever’s disease symptoms. Methods: Systematic searches were conducted in October 2023 in PubMed, Web of Science, Scopus, SportDiscus, and PEDro, using terms like Osteochondritis, Osteochondrosis, Apophysitis, Sever’s disease, Calcaneus, Adolescent, Child, and Childhood. The PEDro scale gauged methodological quality, and the Cochrane Risk of Bias tool evaluated the risk of bias. Results: Eight randomized controlled studies were included, featuring commonly used treatments such as insoles, therapeutic exercises, Kinesio taping, and foot orthoses. The methodological quality was generally good, with an average PEDro score of 6.75 points. Regarding bias, four articles had low risk, three had high risk, and one had some concern. Conclusions: Conservative treatment emerges as an effective option for alleviating symptoms associated with Sever’s disease. Full article

(This article belongs to the Special Issue Rehabilitation and Recovery from Orthopedic Trauma)

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